Spine
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Calf and human cadaveric spines were used to determine motion segment stiffness and laxity after implantation of threaded inserts (the Ray Threaded Fusion Cage, Surgical Dynamics, Inc., Concord, CA), comparing direction of placement, number of implants, shape of the device, and integrity of anterior spine structures. Stiffness and laxity of spines with inserts were compared with those with bone grafts, with and without posterior fixation plates. ⋯ Threaded inserts increase vertebral motion segment stiffness and decrease laxity by distracting intervertebral structures. They are not sensitive to placement, except if vertebral structures are injured during insertion and produce constructs with more consistent mechanical properties than bone grafts.
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This study retrospectively reviewed the outcomes of 11 patients treated for a cervical spine injury with a tracheostomy placed before anterior cervical spine surgery. ⋯ The authors concluded that in patients with cervical cord damage resulting from nonpenetrating trauma, tracheostomy was not found to increase the risk of infection in subsequent anterior cervical surgery. Careful preparation of the skin and placement of the second surgical incision lateral to the tracheostomy site is recommended. Anterior cervical spine surgery remains a viable treatment option in this severely injured patient population.
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Seventy patients (average age, 13.8 years) with adolescent idiopathic right thoracic scoliosis had full assessment of pulmonary functions and radiographic evaluation of spinal and thoracic cage deformities and their flexibilities. ⋯ Deformities in coronal and transverse plane influence changes in pulmonary functions expressed as the percent of predicted values, whereas sagittal plane deformities influence mainly those absolute volumes in which residual volume is a component. It is suggested that rotational flexibility combined with other deformities could be evaluated in future studies on prediction of pulmonary function from the measurements of the deformity.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of spinal flexion and extension exercises and their associated postures in patients with acute low back pain.
A prospective randomized clinical trial compared the effects of flexion and extension back exercises and postures among soldiers with acute low back pain. ⋯ There was no difference for any outcomes between the flexion or extension exercise groups. However, either exercise was slightly more effective than no exercise when patients with acute low back pain were treated.
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Comparative Study
Use of sensory-evoked potentials recorded from the human occiput for intraoperative physiologic monitoring of the spinal cord.
This is a report of a prospective case series. ⋯ Evoked responses can be reliably recorded from over the occiput and show characteristics independent of the classical somatosensory-evoked potential. These responses are very similar to the cerebellar-evoked potential recently characterized in animals and may provide a method for assessing the physiologic integrity of the ventral tracts of the spinal cord in humans.